This Life Events Guide page has two sections - active employees and retirees. Please refer to the appropriate page section for information based on your employment status. This life event does not apply to survivors.
For Active Employees
You have a new dependent due to:
- Birth, Adoption, or Placement for Adoption
- National Medical Support Notice
- Paternity
- Legal Guardianship
- Transfer of Custody
Birth, Adoption, or Placement for Adoption - Active Employees
Health Insurance & Uniform Dental | Supplemental Benefits | |
---|---|---|
Enrollment opportunity? | Yes, also includes birth of grandchild from your covered dependent under age 18 (Your grandchild becomes ineligible at the end of the month in which the parent, your dependent, turns age 18) | Yes. For members currently not enrolled, member must include the new dependent as part of the enrollment (can not enroll with individual coverage) |
Change coverage from individual to family? | Yes | Yes |
Change coverage from family to individual? | No | No |
Change health plan? | Yes | n/a |
Drop a dependent and keep family coverage? | No | No |
Cancel coverage? | See the You Gain Eligibility for Other Group Medical Coverage page for more information | See the You Gain Eligibility for Other Group Medical Coverage page for more information |
Deadline to submit changes | To enroll or add dependent: Within 60 days of the event To change plans: Within 30 days of the event | To enroll or add dependent: Within 60 days of the event To change plans: Within 30 days of the event |
How to submit changes | Log in to My Benefits to edit your benefits:
Once you've made changes in My Benefits, reach out to your employer if you'd like to switch health plans. | Log in to My Benefits to edit your benefits:
|
Documentation required? | Yes | Yes |
Effective date | New coverage: Effective on the date of the event Plan change: Effective the first of the month on or after receipt of the application | New coverage: Effective on the date of the event |
National Medical Support Notice (NMSN) - Active Employees
Health Insurance & Uniform Dental | Supplemental Benefits | |
---|---|---|
Enrollment opportunity? | Yes | Yes. For members currently not enrolled, member must include the new dependent as part of the enrollment (can not enroll with individual coverage) |
Change coverage from individual to family? | Yes | Yes |
Change coverage from family to individual? | No | No |
Change health plan? | Yes | n/a |
Drop a dependent and keep family coverage? | No | No |
Cancel coverage? | See the You Gain Eligibility for Other Group Medical Coverage page for more information | Yes, must provide proof you gained coverage comparable to the supplemental plan in which the employee is canceling |
Deadline to submit changes | To enroll or add dependent: Within 60 days of the event To change plans: Within 30 days of the event | To enroll or add dependent: Within 60 days of the event To change plans: Within 30 days of the event |
How to submit changes | Submit the Health Insurance Application/Change Form (ET-2301) with required documentation for newly added dependents to your employer. | Submit the Supplemental Insurance Application/Change (ET-2339) to with required documentation for newly added dependents to your employer. |
Documentation required? | Yes | Yes |
Effective date | New coverage: Effective on the first of the month on or after receipt of the application, or the date specified on the NMSN, if one is specified Plan change: Effective the first of the month on or after the receipt of the application | New coverage: Effective on the first of the month on or after receipt of the application, or the date specified on the NMSN, if one is specified |
Paternity - Active Employees
Health Insurance & Uniform Dental | Supplemental Benefits | |
---|---|---|
Enrollment opportunity? | Yes | Yes. For members currently not enrolled, member must include the new dependent as part of the enrollment (can not enroll with individual coverage) |
Change coverage from individual to family? | Yes | Yes |
Change coverage from family to individual? | No | No |
Change health plan? | Yes | n/a |
Drop a dependent and keep family coverage? | No | No |
Cancel coverage? | See the You Gain Eligibility for Other Group Medical Coverage page for more information | See the You Gain Eligibility for Other Group Medical Coverage page for more information |
Deadline to submit application | To enroll or add dependent: Within 60 days of the event. Children born outside of marriage become dependents of the father on the date of the court order declaring paternity, on the date the acknowledgment of paternity is filed with the Department of Health Services (or equivalent if the birth was outside of the state of Wisconsin), or on the date of birth with a birth certificate listing the father's name To change plans: Within 30 days of the event | To enroll: Within 60 days of the event To cancel or change: Within 30 days of the event |
How to submit changes | Within 60 days of birth: Log in to My Benefits to edit your benefits:
Once you've made changes in My Benefits, reach out to your employer if you'd like to switch health plans. More than 60 days after birth: Submit the Health Insurance Application/Change Form (ET-2301) with required documentation for newly added dependents to your employer. | Within 60 days of birth: Log in to My Benefits to edit your benefits:
More than 60 days after birth: Submit the Supplemental Insurance Application/Change (ET-2339) to with required documentation for newly added dependents to your employer. |
Documentation required? | Yes | Yes |
Effective date | Birth certificate or statement of paternity is filed within 60 days of birth: New coverage is effective on date of birth Application is filed more than 60 days after birth, without a birth certificate: New coverage is effective on the first of the month following the receipt of application Plan change: Effective the first of the month on or after the receipt of the application | Birth certificate or statement of paternity is filed within 60 days of birth: New coverage is effective on date of birth Application is filed more than 60 days after birth, without a birth certificate: New coverage is effective on the first of the month following the receipt of application |
Legal Guardianship - Active Employees
Health Insurance & Uniform Dental | Supplemental Benefits | |
---|---|---|
Enrollment opportunity? | Yes | Yes |
Change coverage from individual to family? | Yes | Yes |
Change coverage from family to individual? | No | No |
Change health plan? | Yes | n/a |
Drop a dependent and keep family coverage? | No | No |
Cancel coverage? | See the You Gain Eligibility for Other Group Medical Coverage page for more information | See the You Gain Eligibility for Other Group Medical Coverage page for more information |
Deadline to submit application | To enroll or add dependent: File an application with your employer within 60 days of the event To change plans: File an application with your employer within 30 days of the event | To enroll: File an application with your employer within 60 days of the event To change or cancel: File an application with your employer within 30 days of the event |
How to submit changes | Log in to My Benefits to edit your benefits:
Once you've made changes in My Benefits, reach out to your employer if you'd like to switch health plans. | Log in to My Benefits to edit your benefits:
|
Documentation required? | Yes | Yes |
Effective date | New coverage: Effective on the date of the event Plan change: Effective the first of the month on or after the receipt of the application | New coverage: Effective on the date of the event |
Custody Transfer - Active Employees
Health Insurance & Uniform Dental | Supplemental Benefits | |
---|---|---|
Enrollment opportunity? | Yes | Yes. For members currently not enrolled, member must include the new dependent as part of the enrollment (can not enroll with individual coverage) |
Change coverage from individual to family? | Yes | Yes |
Change coverage from family to individual? | No | No |
Change health plan? | Yes | n/a |
Drop a dependent and keep family coverage? | No | No |
Cancel coverage? | See the You Gain Eligibility for Other Group Medical Coverage page for more information | See the You Gain Eligibility for Other Group Medical Coverage page for more information |
Deadline to submit application | Within 30 days of the event | Within 30 days of the event |
How to submit changes | Log in to My Benefits to edit your benefits:
Once you've made changes in My Benefits, reach out to your employer if you'd like to switch health plans. | Log in to My Benefits to edit your benefits:
|
Documentation required? | Yes | Yes |
Effective date | New coverage: Effective on the date of the event Plan change: Effective the first of the month on or after the receipt of the application | New coverage: Effective on the date of the event |
For Retirees
You have a new dependent due to:
- Birth, Adoption, or Placement for Adoption
- National Medical Support Notice
- Paternity
- Legal Guardianship
- Transfer of Custody
Birth, Adoption, or Placement for Adoption - Retirees
Health Insurance & Uniform Dental | Supplemental Benefits | |
---|---|---|
Enrollment opportunity? | No | Yes. For members currently not enrolled, member must include the new dependent as part of the enrollment (can not enroll with individual coverage) |
Change coverage from individual to family? | Yes | Yes |
Change coverage from family to individual? | Yes | No |
Change health plan? | Yes | n/a |
Drop a dependent and keep family coverage? | No | No |
Cancel coverage? | Yes | Yes, must provide proof you gained coverage comparable to the supplemental plan in which the employee is canceling |
Deadline to submit changes | To change to family coverage or add a dependent: Within 60 days of the event To change plans or cancel: Within 30 days of the event | To enroll: Within 60 days of the event To change or cancel: Within 30 days of the event |
How to submit changes | Submit the Health Insurance Application/Change for Retirees (ET-2331) with required documentation to ETF. | Submit the Supplemental Insurance Application/Change (ET-2339) with required documentation to ETF. |
Documentation required? | Yes | Yes |
Effective date | Coverage change: Effective on the date of the event Plan change: Effective the first of the month on or after the receipt of the application Canceling coverage: Effective the last day of the month following receipt of the application | Coverage change: Effective on the date of the event Canceling coverage: Effective the last day of the month following receipt of the application |
National Medical Support Notice (NMSN) - Retirees
Health Insurance & Uniform Dental | Supplemental Benefits | |
---|---|---|
Enrollment opportunity? | No | Yes. For members currently not enrolled, member must include the new dependent as part of the enrollment (can not enroll with individual coverage) |
Change coverage from individual to family? | Yes | Yes |
Change coverage from family to individual? | Yes | No |
Change health plan? | Yes | n/a |
Drop a dependent and keep family coverage? | No | No |
Cancel coverage? | Yes | Yes, must provide proof you gained coverage comparable to the supplemental plan in which the employee is canceling |
Deadline to submit changes | To change to family coverage or add a dependent: Within 60 days of the event To change plans or cancel: Within 30 days of the event | To enroll: Within 60 days of the event To change or cancel: Within 30 days of the event |
How to submit changes | Submit the Health Insurance Application/Change for Retirees (ET-2331) with required documentation to ETF. | Submit the Supplemental Insurance Application/Change (ET-2339) with required documentation to ETF. |
Documentation required? | Yes | Yes |
Effective date | New dependent coverage: Effective on the first of the month on or after receipt of the application, or the date specified on the NMSN, if one is specified Plan change: Effective the first of the month on or after the receipt of the application Canceling coverage: Effective the last day of the month following receipt of the application | New dependent coverage: Effective on the first of the month on or after receipt of the application, or the date specified on the NMSN, if one is specified Coverage change: Effective on the date of the event Canceling coverage: Effective the last day of the month following receipt of the application |
Paternity - Retirees
Health Insurance & Uniform Dental | Supplemental Benefits | |
---|---|---|
Enrollment opportunity? | No | Yes. For members currently not enrolled, member must include the new dependent as part of the enrollment (can not enroll with individual coverage) |
Change coverage from individual to family? | Yes | Yes |
Change coverage from family to individual? | Yes | No |
Change health plan? | Yes | n/a |
Drop a dependent and keep family coverage? | No | No |
Cancel coverage? | Yes | Yes, must provide proof you gained coverage comparable to the supplemental plan in which the employee is canceling |
Deadline to submit changes | To change to family coverage or add a dependent: Within 60 days of the event. Children born outside of marriage become dependents of the father on the date of the court order declaring paternity, on the date the acknowledgment of paternity is filed with the Department of Health Services (or equivalent if the birth was outside of the state of Wisconsin), or on the date of birth with a birth certificate listing the father's name To change plans or cancel: Within 30 days of the event | To enroll: Within 60 days of the event To cancel or change: Within 30 days of the event |
How to submit changes | Submit the Health Insurance Application/Change for Retirees (ET-2331) with required documentation to ETF. | Submit the Supplemental Insurance Application/Change (ET-2339) with required documentation to ETF. |
Documentation required? | Yes | Yes |
Effective date | Birth certificate or statement of paternity is filed within 60 days of birth: Family coverage is effective on date of birth Application is filed more than 60 days after birth, without a birth certificate: Family coverage is effective on the first of the month following the receipt of application Plan change: Effective the first of the month on or after the receipt of the application Canceling coverage: Effective the last day of the month following receipt of the application | Birth certificate or statement of paternity is filed within 60 days of birth: Coverage is effective on date of birth Application is filed more than 60 days after birth, without a birth certificate: Coverage is effective on the first of the month following the receipt of application Canceling coverage: Effective the last day of the month following receipt of the application |
Legal Guardianship - Retirees
Health Insurance & Uniform Dental | Supplemental Benefits | |
---|---|---|
Enrollment opportunity? | No | Yes. For members currently not enrolled, member must include the new dependent as part of the enrollment (can not enroll with individual coverage) |
Change coverage from individual to family? | Yes | Yes |
Change coverage from family to individual? | Yes | No |
Change health plan? | Yes | n/a |
Drop a dependent and keep family coverage? | No | No |
Cancel coverage? | Yes | Yes, must provide proof you gained coverage comparable to the supplemental plan in which the employee is canceling |
Deadline to submit changes | To change to family coverage or add a dependent: Within 60 days of the event To change plans or cancel: Within 30 days of the event | To enroll: Within 60 days of the event To change or cancel: Within 30 days of the event |
How to submit changes | Submit the Health Insurance Application/Change for Retirees (ET-2331) with required documentation to ETF. | Submit the Supplemental Insurance Application/Change (ET-2339) with required documentation to ETF. |
Documentation required? | Yes | Yes |
Effective date | Change to family coverage or adding a dependent: Effective on the date of the event Plan change: Effective the first of the month on or after the receipt of the application Canceling coverage: Effective the last day of the month following receipt of the application | New coverage: Effective on the date of the event Canceling coverage: Effective the last day of the month following receipt of the application |
Custody Transfer - Retirees
Health Insurance & Uniform Dental | Supplemental Benefits | |
---|---|---|
Enrollment opportunity? | No | Yes. For members currently not enrolled, member must include the new dependent as part of the enrollment (can not enroll with individual coverage) |
Change coverage from individual to family? | Yes | Yes |
Change coverage from family to individual? | Yes | No |
Change health plan? | Yes | n/a |
Drop a dependent and keep family coverage? | No | No |
Cancel coverage? | Yes | Yes, must provide proof you gained coverage comparable to the supplemental plan in which the employee is canceling |
Deadline to submit changes | Within 30 days of the event | Within 30 days of the event |
How to submit changes | Submit the Health Insurance Application/Change for Retirees (ET-2331) with required documentation to ETF. | Submit the Supplemental Insurance Application/Change (ET-2339) with required documentation to ETF. |
Documentation required? | Yes | Yes |
Effective date | Change to family coverage or adding a dependent: Effective on the date of the event Plan change: Effective the first of the month on or after the receipt of the application Canceling coverage: Effective the last day of the month following receipt of the application | New coverage: Effective on the date of the event Canceling coverage: Effective the last day of the month following receipt of the application |